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Published online December 7, 2009
PEDIATRICS Vol. 125 No. 1 January 2010, pp. 145-151 (doi:10.1542/peds.2009-0103)
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ARTICLE

Asthma and Behavior in Homeless 4- to 7-Year-Olds

J.J. Cutuli, MAa, Janette E. Herbers, MAa, Maria Rinaldi, MS, MPHb, Ann S. Masten, PhDa, Charles N. Oberg, MD, MPHb

a Institute of Child Development
b Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota

OBJECTIVE: Low-income, urban, ethnic minority children have higher rates of asthma, more severe symptoms, and more management issues, as well as high risk for academic and behavior problems. This study focused on asthma reported in young children who resided in a family emergency homeless shelter. Asthma rates were considered along with their relation to hospitalization and emergency department use and behavior that is important for school success, including cognitive function, conduct, and academic functioning.

METHODS: A total of 104 children (age 4.0–7.5 years) and parents were recruited while residing in an urban emergency homeless shelter for families. Children had no previously identified developmental delays and spoke English proficiently. Parents reported whether the child experienced asthma, as well as emergency department use and hospitalization. Parents and teachers completed measures of child inattention/hyperactivity and behavior problems. Cognitive function of children was directly assessed.

RESULTS: Asthma was reported for 27.9% of children, ~3 times the national average. Children with asthma had been hospitalized more often, showed higher levels of inattention/hyperactivity and behavior problems, and evidenced lower academic functioning.

CONCLUSIONS: Young children in homeless family emergency shelters have high rates of asthma and related problems that could lead to higher hospitalization rates, more behavioral problems, and lower academic functioning at school. Screening and treatment of children who stay in emergency family shelters may be particularly important for reducing risks associated with asthma in highly mobile, low-income families.

Key Words: homeless • asthma • disparity • academic function • conduct problems • ADHD • executive function

Abbreviations: ADHD—attention-deficit/hyperactivity disorder • ED—emergency department • EF—executive function • HBQ—Health and Behavior Questionnaire • NS—not significant • ANCOVA—analysis of covariance • CI—confidence interval

Accepted Jul 28, 2009.


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